We were sent a question about the typical body temperature of people with Down syndrome and how they regulate their body temperature.
Our review of the medical literature found little information. We found one article from Poland that compared body temperatures of people with Down syndrome to people without Down syndrome both at rest and after exercise (1). At rest, the surface body temperatures (temperatures at the skin) for men and women with Down syndrome were lower in all regions of the body compared to people without Down syndrome. Fifteen minutes after exercise, the surface body temperatures of those without Down syndrome were higher than the temperatures before exercising. Their bodies appropriately shifted blood to the skin surface. This raises the temperature of the skin but cools off the body. In contrast, the surface body temperatures of those with Down syndrome were lower than the temperatures before exercising. Their bodies did not appropriately shift blood to the skin surface to cool off their bodies.
Sweating is another way our bodies regulate temperature. The surface of our skin cools when the water in sweat evaporates. In our experience, some (or many) people with Down syndrome sweat less than others. This can cause the body temperatures of those individuals to rise when they exercise, are in a warm room, or are outside in warm weather. We have an article called "Warning Signs a Person with Down Syndrome is Getting Overheated" that shares more information.
Another consideration for people with Down syndrome is the higher frequency of underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism). When these conditions are not treated, the body temperature may be lower if a person has hypothyroidism or higher if a person has hyperthyroidism.
What are the implications?
The implications are not entirely clear. We do not have "hard and fast recommendations." A few things to consider:
Fever may not be a reliable measure of infection in some people with Down syndrome. We see some individuals who seem not to get a fever when they have an infection.
When the outside or room temperature is high, people with Down syndrome may not be able to cool down in the typical fashion. They may need to drink more cool water, take more breaks, or move to a cooler place. In a warm room, an elevated body temperature may not be a fever but may be related to a reduced ability to cool off.
Some people with Down syndrome may be more susceptible to cold temperatures. They may need to dress more warmly or move to a warmer place sooner than someone else.
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- Debiec-Bak A, Wojtowicz D, Pawik L, et al. Analysis of body surface temperatures in people with Down syndrome after general rehabilitation exercise. J Therm Anal Calorim 135, 2399-2410. https://doi.org/10.1007/s10973-018-7345-1